| NPI | 1083663769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA09739300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD015356E) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2021-06-23 |